Inspection and Regulation

10.01.10

CQC lifts registration conditions on Tameside NHS Foundation Trust

CQC lifts registration conditions on Tameside NHS Foundation Trust. Regulator says it will continue to check improvements.

The Care Quality Commission said Tameside NHS Foundation Trust had made necessary improvements to staffing levels and co-ordination of staffing rosters.

CQC said it would now lift the two conditions it had imposed on the trust’s licence, but stressed that the trust must continue with improvements to quality and safety.

CQC imposed the conditions on 1 April, when it introduced a tough new registration system for NHS trusts. Evidence collected from the hospital, on-site inspection and interviews with local patient groups had shown that on some wards there were not enough suitably qualified staff to meet the needs of patients.

It required the trust to take urgent action to ensure:

there are a sufficient number of qualified and experienced staff to meet the needs of patients admitted to Tameside General Hospital.
systems are in place to manage and co-ordinate staff so that all wards have enough qualified staff to care for patients.

CQC set a deadline of 30 April for the trust to implement staffing improvements and the trust was required to provide evidence of working systems by 31 May.

To check whether the necessary improvements had been made, CQC made an unannounced site visit to Tameside General Hospital on 16 June. Inspectors visited four adult medicine wards, talked to patients, visitors and staff and examined in detail the care provided to a sample of 11 patients.

It also requested documentary evidence from the trust; reviewed findings from previous inspections and information from other sources, such as Local Involvement Networks and the strategic health authority.

CQC found that quality and safety of care, treatment and support for patients had improved since the March inspection. It reported that:

the trust has committed to employing an additional 54 full time staff, most of which have been recruited and are starting work in June and July.
there was a permanent team of suitably skilled nurses on each of the wards visited that does not rely on external or agency nursing staff.
patients interviewed were mostly positive about their care and said staff were available to assist when necessary.
the wards inspected were clean and well organised.
no patients on the wards were sharing accommodation with the opposite sex.
recently recruited staff said they had received induction training, had been appointed a mentor and were receiving support from the ward manager.

CQC also identified some areas for further improvement and the trust is already taking action to ensure this work is completed. CQC will closely monitor these areas and check that this has resulted in improvements for patients.

Areas for continued improvement are:

Not all of the care plans CQC examined were complete, meaning that patients may not have all of their needs identified and assessed. Additionally, some patients had no plan for discharge or a planned date for discharge. The trust is undertaking work to reduce delays in discharge and CQC notes that the number of medically fit patients remaining in hospital has fallen since the beginning of the year. However, it remains concerned that some patients may remain in hospital longer than is necessary.
From interviews with patients and examining individual records, CQC found evidence that some patients needed additional support or monitoring to ensure nutritional needs are met.
The trust is completing its work on staffing improvements and will need to demonstrate that it can sustain that improvement in the longer term, including periods of additional demand in the winter months.

Sue McMillan, Regional Director, Care Quality Commission in the North West says,

“We arrived at the hospital unannounced, so we could see the wards as patients do. We noted significant improvements to the quality and safety of care since our last inspection in March. No doubt a great deal of this has been due to the increase in nurses on the wards and the support provided to staff.

“Patients were broadly positive about their care and we received very few negative comments from patients, visitors or staff. However, we did identify some instances in which care was not to the standard it should have been.

“While we have removed the conditions from the trust’s licence, we expect to see continuing improvements in staffing, making sure patients get the right nutrition, discharging patients at the right time and ensuring that records are accurate and up-to-date. The trust has committed to making these improvements and we will monitor progress.
“We would like to thank the patients, visitors and staff who provided us with vital evidence during our visit.”

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